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Nanjing Heart Center
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Nanjing First Hospital, Nanjing Medical University
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Asian Heart Society (AHS)
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Haimei Xu +86-13914736846
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Ling Lin : +86 (25) 52271398
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Yingying Zhao :+86-13815408517
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Recommended Paper
Management of Acute Myocardial Infarction During the COVID-19 Pandemic
COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up
CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic
ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)
急性冠脉综合征
Original Research2018 Oct 6. pii: S1885-5857(18)30360-8.
JOURNAL：Rev Esp Cardiol (Engl Ed). Article Link
Ahn JH, Yang JH, Choi SH et al. Keywords: CTO; OMT; proximal or middle left anterior descending artery;
INTRODUCTION AND OBJECTIVES - Limited data are available on the clinical outcomes of optimal medical therapy (OMT) compared with revascularization by percutaneous coronary intervention (PCI) in patients with chronic total coronary occlusion (CTO) of the proximal or middle left anterior descending artery (pmLAD). Therefore, the objective of this study was to compare the long-term outcomes of patients with pmLAD CTO who were treated with a PCI strategy with those of patients treated with an OMT strategy.
METHODS - Between March 2003 and February 2012, 2024 patients with CTO were enrolled in a single-center registry. Among this patient group, we excluded CTO patients who underwent coronary artery bypass grafting. After the exclusion, a total of 1547 patients remained. They were stratified according to classification of coronary segments (pmLAD or non-pmLAD CTO) and the initial treatment strategy (OMT or PCI). Propensity score matching was performed. The primary outcome was cardiac death.
RESULTS - The median follow-up was 45.9 (interquartile range, 22.9-71.1) months. After propensity score matching, the incidence of cardiac death (HR, 0.54; 95%C, 0.31-0.94, P=.029) was significantly lower in the PCI with pmLAD CTO group than in the OMT group. In contrast, no significant difference was found in the rate of cardiac death between the PCI and OMT groups with non-pmLAD CTO (HR, 0.62; 95%CI, 0.27-1.42, P=.26).
CONCLUSIONS - As an initial treatment strategy, PCI of pmLAD CTO, but not PCI of non-pmLAD, is associated with improved long-term survival.
Copyright © 2018. Published by Elsevier España, S.L.U.
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